Healthcare Quality Assurance Manager

Role Overview

This registered nurse reviews clinical records before they are finalized, checking that nursing notes and related documentation are complete, accurate, and consistent with the plan of care. The role helps safeguard care quality and support appropriate reimbursement by identifying documentation gaps, working with care teams to resolve them, and turning recurring issues into practical guidance and improvement efforts.

Key Responsibilities

• Check nurses’ notes for accuracy and completeness before electronic submission, returning records that need correction.
• Compare nursing documentation with physician orders, medication profiles, aide care plans, and the patient’s established plan of care.
• Review Medicaid and other episodic-payer records for evidence of appropriate care, visit use, physician contact, care-plan adherence, and coordination between disciplines.
• Work with clinicians, attending physicians, caregivers, and administrative colleagues to address care-planning questions and documentation concerns.
• Track recurring documentation deficiencies, flag clinical quality concerns, and share clear instructions for correcting identified issues.
• Contribute to performance improvement work and keep clinical knowledge current through available internal and external training.
• Attend biweekly meetings to discuss quality assurance and clinical review issues, and prepare weekly summaries of records reviewed and concerns requiring follow-up.
• Carry out additional duties as assigned, managing competing priorities with sound judgment and professionalism.

Requirements & Qualifications

• Bachelor’s degree in Nursing.
• Current registered nurse licensure in good standing.
• At least three years of professional experience.
• Strong written and verbal communication skills, with the ability to explain documentation requirements to clinical and administrative staff.
• Excellent organization and attention to detail, including the ability to manage multiple tasks in a fast-paced setting.
• Independent judgment, practical problem-solving ability, and confidence applying written, verbal, or diagram-based instructions.
• Ability to work effectively both independently and as part of a team, while maintaining a professional and constructive approach.